P AHO’ sPol i c y onRes ear c h f orHeal t h
PAHO’s Policy on Research for Health PAHO Research for Health Policy Approved during the 61st Session of the Directing Council of 2009. © PAHO 2010 Product of the Research Promotion and Development team Edited by Joanne McManus Photos by Jane Dempster, © PAHO Financed in part by a generous contribution of the Agencia Española de Cooperación Internacional para el Desarrollo, AECID. Also available in Spanish, Portuguese, and French in full text, under Creative Commons Attribution 3.0 Unported licence at www.paho.org/researchportal/policy
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Content
PAHO’s Policy on Research for Health..........................1 Background and Rationale.............................................5 Guiding Principles and Values.......................................9 Goals and Objectives ...................................................13 Six objectives ...............................................................13 Quality ...........................................................................14 Governance ..................................................................14 Human resources ........................................................14 Partnership ...................................................................15 Standards .....................................................................15 Impact ..........................................................................16 PAHO’s Commitment to Implementation ...................19
Policy on Research for Health
Pan American Health Organization
Policy on Research for Health
Pan American Health Organization
PAHO’s Policy on Research for Health
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he Pan American Health Organization (PAHO) has adopted a new policy on research for health. This policy aims to ensure that PAHO remains true to being a knowledge-based organization, that strong and sustainable national health research systems are found in every country in the Americas, and that research evidence constitutes a cornerstone of all activities aimed at attaining the highest level of health and equity. To achieve these aims the Secretariat at the Pan American Sanitary Bureau, Member States and partners will need to work together to harness science, technology, innovation and broader knowledge. Numerous events during the past decade—from the 1998 World Health Assembly Resolution 43.19 on the role of research in health, to the Ministerial Summit on Health Research in Mexico City in 2004 and the Global Ministerial Forum on Research for Health in Bamako in 2008—resulted in a crescendo of global interest in health research and led to the Region adopting for the first time a regional policy on Research for Health. The term “research for health” reflects the purpose of research and the fact that improving health outcomes requires the involvement of many sectors and disciplines, including those that participate in and are expected to benefit from research.
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The PAHO Policy on Research for Health is an overarching policy that will underpin all of PAHO’s work.1 It will be used to integrate research into other PAHO policies, strategies and action plans aimed at addressing regional needs and strengthening countries’ essential public health functions. The policy will also help harmonize, align and facilitate the implementation of major global research strategies in the Region of the Americas, including WHO’s Strategy on Research for Health2 and the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property3. When implemented the PAHO Policy on Research for Health will result in a number of tangible benefits for countries, including: • increased awareness of and access to methodologies for setting national priorities to address their most pressing health problems; •
access to models of strong regulatory frameworks and structures, including the use of available tools to register and follow research projects systematically and to ensure adherence to the highest ethical and quality standards for research;
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a national workforce capable of conducting research and using it to inform the development of health policy;
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improved production, use and communication of reliable, relevant and timely evidence and information.
1. The official version of the Policy is available as document CD49/10 at http://new.paho.org/hq/index.php?option=com_content&task=view&id=1640&Itemid=1425&lang=en 2. See http://www.who.int/rpc/research_strategy/en/
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In a nutshell, the policy will facilitate the creation and enhancement of robust national health research systems supported by strong multisectoral and multidisciplinary teams. Countries will be able to more effectively engage with external research institutions and partners in ways that advance their national agendas and to make more efficient use of their limited resources. The policy also represents an opportunity for PAHO to review and revitalize the role of research within PAHO, as well as PAHO’s role in the relevant research performed in the Region. It will be instrumental in enhancing PAHO’s support to Member States in building research capacity to produce, share and use knowledge from scientific evidence, and it will strengthen PAHO’s leadership role in influencing the regional research for health agenda. Finally, the policy will help PAHO better communicate its involvement in research for health.
3. See http://apps.who.int/gb/ebwha/pdf_files/A61/A61_R21-en.pdf
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Background and Rationale
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ver the past decade funding for global health and health research has risen dramatically, and numerous global heath research initiatives have emerged. Increased attention has been paid to health systems research, evidenceinformed policy and practice, and the political, economic, environmental and social determinants of health. At the same time, national governments, PAHO/WHO, the international research community and other partners have been calling for the development and strengthening of national health research systems, which are essential to improve population health, reduce inequities and social injustice, and attain the Millennium Development Goals. Although the importance of such systems has been widely acknowledged, much needs to be done to build capability in research and innovation in low- and middle-income countries, including those in the Region of the Americas.4
The fundamental importance of research for WHO is reflected in its Constitution, in the eleventh General 4. Comité Ejecutivo, Primera Conferencia Latinoamericana sobre Investigación e Innovación en Salud 2008. 1ª Conferencia Latinoamericana sobre Investigación e Innovación en Salud. [Report of the 1st Latin American Conference on Research and Innovation for Health]. Available at (original in Spanish and translations) http://new.paho.org/CLAIIPS2008.
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Programme of Work, 2006-2015, and in its six central core functions, which consider or require research competencies for their fulfillment. Research also has been a core function and priority for the Pan American Sanitary Bureau (PASB) since 1924, as reflected in the Pan American Sanitary Code, and is central to PAHO’s mission. Although research is specifically addressed in PAHO’s current main policy and planning documents, this is the first time Member States have endorsed an explicit research policy.
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Policy on Research for Health
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Guiding Principles and Values
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hen undertaking activities related to research and the use of scientific evidence, PAHO will be guided by the Organization’s values of equity, excellence, solidarity, respect and integrity and will consider cross-cutting priorities (such as gender equality, ethnicity, social protection, health promotion, human rights and primary health care). In addition to these organizational values, PAHO’s Policy on Research for Health is grounded in four principles that will guide the achievement of its goals and objectives. • Impact means focusing on research and innovation that addresses identified health priorities at the country, subregional and regional levels, and fostering timely, responsible and appropriate use of research outputs for the improvement of public health and its policies and practices. •
Quality refers to the promotion, production and use of high-quality research that is ethical, effective, efficient, accessible to all, and monitored and evaluated by experts.
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Inclusiveness is about working in partnership with Member States and stakeholders, taking a multisectoral approach to research for health, and promoting the participation of communities and civil society in every relevant aspect of the research process, taking into account gender, cultural, and human rights dimensions.
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Communication and accessibility mean effectively communicating research activities to the public in a timely and relevant manner, enabling free and unrestricted access to the research PAHO supports, and encouraging other agencies and partners that fund or perform research to do the same.
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Policy on Research for Health
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Goals and Objectives
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his section briefly describes the policy’s six interrelated objectives5 (see box). The official document sets out several actions PASB will take to achieve each objective. These diverse actions range from developing research tools to promoting the good conduct and use of research within the Organization and among Member States. Six objectives 1. Promote the generation of relevant, ethical, and quality research. 2. Strengthen research governance and promote the definition of research agendas. 3. Improve competencies of and support for human resources involved in research. 4. Seek efficiencies and enhanced impact and appropriation of research through effective and strategic alliances, collaboration, and the building of public trust and engagement in research. 5. Foster best practices and enhanced standards for research. 6. Promote the dissemination and utilization of research findings.
5. The six objectives are consistent and synergistic with the five goals of WHO’s Strategy on Research for Health, which are: to strengthen the research culture across WHO; to champion research that addresses priority health needs; to support the development of robust national health research systems; to promote good research practice; and to strengthen the links between policy, practice, and the outcome of the research.
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Quality As a knowledge-based organization committed to providing informed technical cooperation to its Member States, PAHO aims to sponsor, support, fund and conduct ethical, high-quality research that addresses present and future health needs and that contributes towards the development of global public goods. The PAHO Policy on Research for Health represents a major step towards integrating research into the planning, implementation, monitoring and evaluation of all PAHO policies, programs, projects and activities.
Governance Good governance is a pillar of robust national health research systems and an essential part of all organizations and institutions involved in research for health, Good governance steers the research agenda, promotes efficiencies, minimizes duplication and encourages effective shared leadership. PASB will use the research policy to strengthen its internal research governance structures and to assist and support national health authorities and other relevant sectors, notably science and technology and education, to do the same.
Human resources PAHO considers researchers to be an irreplaceable asset for sustainable development. All countries need to invest in education, training, recruitment and retention of researchers in both basic and applied sciences, while seeking a balanced gender and
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ethnic representation and participation in research. In addition, health professionals, policy makers (in health as well as in other sectors that affect health), the media and the public need different sets of skills to seek, understand and interpret research results that can inform their decisions and actions.
Partnership The need to encourage partnerships, networking and joint research has been acknowledged, as has been the formation of new strategic alliances among funding agencies, academic institutions, centers of excellence, and WHO collaborating centers and the reinforcement of old alliances. By working together, ministries of health, scientific and academic institutions, the non-state sector and communities can seek consensus so that research targets and addresses national priorities, especially when it is state funded.
Standards International norms, standards and guidelines are required to govern, manage and improve the quality of research, to address inefficiencies in the research process, to promote transparency and to improve access to information. They are essential to maintaining public trust, confidence and participation in research. International support is growing for the development of a systematic method for selecting, developing, adopting and evaluating new standards and norms in line with priorities in research for health. Such norms and standards must take into account general ethi-
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cal principles,6 human rights, equality and availability of resources, as well as the political, cultural and environmental context in which they will be applied.
Impact Information and communications technologies can be used to give visibility to regional research and to disseminate and promote the use of knowledge to improve health, equity, and development. Researchers, policy makers, health practitioners and the public require timely and equitable access to research evidence. Strategies to bolster understanding of the essential links between research, policy and action need to be developed, implemented and evaluated.
6. Council for International Organizations of Medical Sciences (CIOMS). International Ethical Guidelines for Biomedical Research Involving Human Subjects); 2002. Available at http://www.cioms.ch/frame_guidelines_nov_2002.htm.
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PAHO’s Commitment to Implementation
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eadquarters, country offices and specialized centers will work with ministries of health, other sectors, non-governmental organizations, the UN system, the inter-American system, development agencies and civil society organizations to improve the integration of innovation and evidence into health systems and health care across the Americas. Human and financial resources for health research will be monitored and incentives developed. “Integrating research into all PAHO technical areas is essential to ensure that what we do makes a difference. The Policy on Research for Health is an excellent vehicle for systematically incorporating relevant, high quality, and ethical research, thereby ensuring that our programs and actions rest on evidence.� Mirta Roses, Director PAHO
PAHO will lead by example. Within PAHO, research commitments will be reflected in institutional policies and program budgeting and planning, implementation, monitoring and evaluation, human resource management and knowledge management.
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To track progress and to ensure transparency and accountability, the Organization will report regularly on the implementation of this policy and on the development of subsequent strategies and action plans, including how these are harmonized with other related activities. Realizing the six objectives of PAHO’s Policy on Research for Health will take many years. But with sustained political commitment and adequate funding, the new policy will play a catalytic role in fostering evidence-based practice and innovation in all countries in the Americas, which ultimately will help countries improve the health and development of their populations—with equity.
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Policy on Research for Health
P AHO’ sPol i c y onRes ear c h f orHeal t h